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Coalescing skin-colored papules

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The rash’s distinct clinical appearance and the patient’s age pointed to an uncommon diagnosis.


 

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AN 8-YEAR-OLD BOY was evaluated by his family physician for a widespread rash that had first appeared on his arms 4 months earlier. Physical examination revealed 1- to 2-mm hypopigmented, smooth, and dome-shaped papules in clusters and linear arrays on the child’s back, shoulders, and extensor surfaces of both arms (FIGURE). There was no tenderness to palpation of the affected areas, but the patient complained of pruritus. Otherwise, he was in good health.

Multiple hypopigmented micropapules on arm

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